Individual
NICOLLE DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1005 N 35TH AVE, HOLLYWOOD, FL 33021-5402
(954) 265-6301
(954) 985-1434
Mailing address
1117 E HALLANDALE BEACH BLVD, HALLANDALE BEACH, FL 33009-4488
(954) 454-5131
(954) 241-6908
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
ME162273
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118232200
—
FL
Enumeration date
04/11/2017
Last updated
01/16/2024
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